Exploring Integration of Support for Co-Occurring Substance Use-Related Needs in Interdisciplinary Traumatic Brain...

To explore initial outcomes (treatment entry and completion and staff feedback) for an interdisciplinary military traumatic brain injury (TBI) treatment program with individualized support for co-occurring substance use (SU).

A quality improvement effort was undertaken to develop an integrated model of care for TBI with support for service members and veterans (SM/Vs) with co-occurring SU. We describe treatment entry and completion outcomes, along with staff feedback, collected over 26 months of program implementation.

An intensive outpatient program (IOP) for SM/Vs with TBI, administered by a not-for-profit hospital.

Three hundred and sixty-four (N=364) SM/Vs applying for TBI treatment (85.2% men, 28.3% active service, median age of 41 (interquartile range, ±12)).

An Integrated Care Model for TBI + SU was developed and flexibly applied to support client needs, including modifications to assessment, intervention, and follow-up support related to SU.

We report on instances of noncompletion because of SU, percentage of admission denials because of SU, demographic and clinical predictors of entering care, and qualitative feedback from treating clinicians.

Over 26 months, 188 individuals entered care, and just 7 who entered the IOP did not complete, with 1 of these instances because of SU. Clinician attitudes indicate optimism about the Integrated Care Model. Predictors of entering care, analyzed using logistic regression with recursive feature elimination, included multiple demographic (sex, race, location, service status) and clinical (SU and psychiatric history, brain injury symptom severity) characteristics.

An interdisciplinary TBI treatment environment holds promise as a setting for incorporating SU-related support to enhance entry and completion for more SM/Vs.